TY - JOUR
T1 - The effect of a pharmacy-led transitional care program on medication-related problems post-discharge
T2 - A before-After prospective study
AU - Daliri, Sara
AU - Hugtenburg, Jacqueline G.
AU - ter Riet, Gerben
AU - van den Bemt, Bart J. F.
AU - Buurman, Bianca M.
AU - op Reimer, Wilma J. M. Scholte
AU - van Buul-Gast, Marie-Christine
AU - Karapinar-Carkit, Fatma
N1 - Funding Information:
F. Karapinar-Çarkit received a research grant of 84 thousand euros from the Netherlands Organisation for Health Research and Development (ZonMw), grant no: 836044008: https://www. zonmw.nl/nl/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2019 Daliri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2019/3/12
Y1 - 2019/3/12
N2 - BackgroundMedication-related problems are common after hospitalization, for example when changes in patients' medication regimens are accompanied by insufficient patient education, poor information transfer between healthcare providers, and inadequate follow-up post-discharge. We investigated the effect of a pharmacy-led transitional care program on the occurrence of medication-related problems four weeks post-discharge.MethodsA prospective multi-center before-after study was conducted in six departments in total of two hospitals and 50 community pharmacies in the Netherlands. We tested a pharmacy-led program incorporating (i) usual care (medication reconciliation at hospital admission and discharge) combined with, (ii) teach-back at hospital discharge, (iii) improved transfer of medication information to primary healthcare providers and (iv) post-discharge home visit by the patient's own community pharmacist, compared with usual care alone. The difference in medication-related problems four weeks post-discharge, measured by means of a validated telephone-interview protocol, was the primary outcome. Multiple logistic regression analysis was used, adjusting for potential confounders after multiple imputation to deal with missing data.ResultsWe included 234 (January-April 2016) and 222 (July-November 2016) patients in the usual care and intervention group, respectively. Complete data on the primary outcome was available for 400 patients. The proportion of patients with any medication-related problem was 65.9% (211/400) in the usual care group compared to 52.4% (189/400) in the intervention group (p = 0.01). After multiple imputation, the proportion of patients with any medicationrelated problem remained lower in the intervention group (unadjusted odds ratio 0.57; 95% CI 0.38-0.86, adjusted odds ratio 0.50; 95% CI 0.31-0.79).ConclusionsA pharmacy-led transitional care program reduced medication-related problems after discharge. Implementation research is needed to determine how best to embed these interventions in existing processes.
AB - BackgroundMedication-related problems are common after hospitalization, for example when changes in patients' medication regimens are accompanied by insufficient patient education, poor information transfer between healthcare providers, and inadequate follow-up post-discharge. We investigated the effect of a pharmacy-led transitional care program on the occurrence of medication-related problems four weeks post-discharge.MethodsA prospective multi-center before-after study was conducted in six departments in total of two hospitals and 50 community pharmacies in the Netherlands. We tested a pharmacy-led program incorporating (i) usual care (medication reconciliation at hospital admission and discharge) combined with, (ii) teach-back at hospital discharge, (iii) improved transfer of medication information to primary healthcare providers and (iv) post-discharge home visit by the patient's own community pharmacist, compared with usual care alone. The difference in medication-related problems four weeks post-discharge, measured by means of a validated telephone-interview protocol, was the primary outcome. Multiple logistic regression analysis was used, adjusting for potential confounders after multiple imputation to deal with missing data.ResultsWe included 234 (January-April 2016) and 222 (July-November 2016) patients in the usual care and intervention group, respectively. Complete data on the primary outcome was available for 400 patients. The proportion of patients with any medication-related problem was 65.9% (211/400) in the usual care group compared to 52.4% (189/400) in the intervention group (p = 0.01). After multiple imputation, the proportion of patients with any medicationrelated problem remained lower in the intervention group (unadjusted odds ratio 0.57; 95% CI 0.38-0.86, adjusted odds ratio 0.50; 95% CI 0.31-0.79).ConclusionsA pharmacy-led transitional care program reduced medication-related problems after discharge. Implementation research is needed to determine how best to embed these interventions in existing processes.
KW - DRUG-RELATED PROBLEMS
KW - HOSPITAL READMISSIONS
KW - COMMUNITY PHARMACISTS
KW - PATIENT SAFETY
KW - TEACH-BACK
KW - INTERVENTION
KW - DISCHARGE
KW - DISCREPANCIES
KW - RECONCILIATION
KW - INFORMATION
U2 - 10.1371/journal.pone.0213593
DO - 10.1371/journal.pone.0213593
M3 - Article
C2 - 30861042
SN - 1932-6203
VL - 14
JO - PLOS ONE
JF - PLOS ONE
IS - 3
M1 - 0213593
ER -